| Fullerton Medical Group | |
|
2021 Church St Suite 504 Nashville TN 37203-2021 | |
| (615) 284-7900 | |
| (615) 284-3488 |
| Full Name | Fullerton Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 2021 Church St, Nashville, Tennessee |
| Authorized Official Name and Position | Randy Fullerton (GENERAL PARTNER) |
| Authorized Official Contact | 6152847900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fullerton Medical Group 2021 Church St Suite 504 Nashville TN 37203-2021 Ph: () - | Fullerton Medical Group 2021 Church St Suite 504 Nashville TN 37203-2021 Ph: (615) 284-7900 |
| NPI Number | 1477532729 |
|---|---|
| Provider Enumeration Date | 01/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477532729 | NPI | - | NPPES |
| 105694 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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